| NPI | 1871781963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA 0004096) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9104170) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2018-06-29 |